12/17/2022 0 Comments Atlas shrugged full text pdfWe found marked rural/urban disparities, with longer average driving times for patients in rural and small metropolitan counties. For patients at STEMI referral hospitals, 85.6% were at facilities within a 30-minute drive of a high-/medium-volume percutaneous coronary intervention center 90th percentile was 31 minutes. In 2006, 77% of STEMI referral hospitals had transfer travel times within 30 minutes 90th percentile for interhospital driving time was 56 minutes. Differences by geographic location (rural versus urban) and patient race/ethnicity were examined. We plotted transfer travel time cumulative proportion survival curves for hospitals and patients to assess the feasibility of transfer within 30 minutes to higher-volume facilities. Using 2006 Florida hospital discharge data, we calculated driving times between STEMI referral hospitals and the nearest medium-/high-volume percutaneous coronary intervention centers. We investigate the geographic feasibility of achieving timely interfacility transport from STEMI referral hospitals to percutaneous coronary intervention hospitals in Florida. Because many patients present to low-volume or non-percutaneous coronary intervention-capable STEMI referral hospitals, timely percutaneous coronary intervention treatment requires effective transfer systems, which include interfacility transport times of less than 30 minutes. Current guidelines recommend that ST-elevation myocardial infarction (STEMI) patients receive percutaneous coronary intervention less than or equal to 90 minutes from first medical contact, preferably at high-volume percutaneous coronary intervention centers (≥400 percutaneous coronary interventions annually).
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December 2022
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